Ex-Health Secretary Ubial: I was pressured to continue dengue vaccine program

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Metro Manila (CNN Philippines, December 11) — Former Health Secretary Paulyn Ubial on Monday said she was forced to continue carrying out the now-controversial dengue vaccination of her predecessor, Janette Garin.

"People, even in Congress, told me, 'You will go to jail, doctora, if you do not  implement this program because there is a contract. You have to honor that contract,'" she said during the Senate Blue Ribbon Committee and Health Committee probe into the anti-dengue vaccine program mess.

"People were pressuring me to resume its implementation," she added.

Ubial, who was appointed by President Rodrigo Duterte as Health Secretary in June, said she felt she had no choice but to implement the P3.5-billion nationwide immunization program, which started during the time of Garin, despite the possible health risks.

"When I became Health Secretary, it was very difficult for me to implement this program. I was already on damage control... There were issues on long-term safety, so I had to really be very careful in implementing," she said.

Ubial in July 2016 issued a resolution temporarily suspending the school-based dengue immunization program following the recommendation of an expert panel on dengue, composed of independent and uninvolved experts convened by Ubial.

The program was put on hold "pending another round of medical review and in view of reports that Dengvaxia has less than 50 percent protection against dengue serotypes 1 and 2, which are the most common circulating serotypes in the country," the House of Representatives said in November 2016, when it initially conducted the probe.

The expert panel also advised continuing the vaccination for the 489,003 pupils who received the first dose, so they can complete all three doses of Dengvaxia.

"Incomplete dosage is more dangerous," Ubial earlier said in a text message.  

This was one of the reasons why the Department of Health resumed implementing the program September that year.

"Imagine P3 billion-worth of vaccines that were already in the pipeline for procurement, and you will disapprove the program. It's really very difficult," she said.

Around 10 percent of over 830,000 students who were immunized with Dengvaxia, but did not have a prior dengue infection, now face contracting a "serious disease," according to vaccine manufacturer Sanofi Pasteur.

The government also said at least 32,000 private patients were vaccinated with Dengvaxia.

Questionable timing

Ubial questioned the timing of the implementation of the nationwide immunization program. The Aquino administration on April 4 - over a month before the 2016 national elections and end of Garin's term- kicked off its program.

The Blue Ribbon Committee Chair Senator Richard Gordon noted the areas where the program was rolled out —National Capital Region, Region III, and Region IV-A — had the highest voter turnout.

Ubial said the government shouldn't have introduced a new vaccine during the election period because it will "taint" the motive and make it seem there is a "hidden agenda."

"We do not mix health and politics. It will destroy the vaccine even if it is safe," she said.

She added the procurement process should not have political interference.

"If you mix politics and health, it's really a disaster. So the process by which the new vaccine was introduced was messed up," the former health official said.

Ubial said the vaccine was bought without the approval of the FEC (Formulary Executive Council), a group of doctors and medical experts who decide if a drug can be sold in the country.

Related: Dengvaxia controversy timeline

"That created a lot of pressure on all the people who will implement the program," she said.

Ubial added the immunization program should have been carried out in the private sector first before implementing a nationwide vaccination program, as there is a one-on-one relationship between doctor and patient in a private setting as compared to rolling it out nationwide.

The House on Wednesday is also set to tackle the Health Department's controversial dengue vaccine program, which has since been suspended amid health risks.

Sanofi misleading the public?

Senate Blue Ribbon Committee chair Richard Gordon scolded Sanofi officials for misleading the public, after it was revealed that the end phase of the clinical test for the vaccine, or the phase 4 of the efficacy phase,  was not completed.

"I will tell you to your face…I was insulted when we were conducting the investigation here...It is unethical for you to advertise while you're doing this dengue procedures," Gordon said.

Garin also said Sanofi was the real culprit, saying its officials were not transparent in revealing the true nature of the vaccine.

"Maybe if there was no change in the medical advisory...we hope this will really be investigated," she said.

Health Secretary Francisco Duque also accused the drug manufacturer of mental dishonesty. 

"You could have been more forthright and I think they've not been forthright from the beginning," Duque said.

The House is also set to tackle on Wednesday  the Health Department's controversial dengue vaccine program, which has since been suspended amid health risks.